FREQUENTLY ASKED QUESTIONS
Reporting Workers' Compensation Related Injuries FAQ
- What is Workers’ Compensation?
Workers’ Compensation is statutory, no-fault system of legal rules that provides for the payment of medical expenses and wage loss benefits for employees who are injured or contract an illness arising directly out of and in the course and scope of their job duties.
- How do I file a Workers’ Compensation claim?
Please refer to Reporting and Managing a Workers’ Compensation Claim.
- Who will handle my claim?
The University of Minnesota contracts with a Third Party Administrator (TPA) to handle the administration of Workers’ Compensation claims. Your claim will be assigned to an adjuster at Sedgwick CMS, the TPA under contract with the University.
- What benefits am I entitled to?
Very briefly, under the Minnesota law, you may be entitled to:
- Medical services related to your work injury.
- Compensation for wage loss or inability to earn a full income.
- Benefits to dependents for work-related death.
- Compensation for loss of use of a part of the body or loss of a body part.
- Vocational rehabilitation services if you are unable to return to the job or to the employer you had before the injury.
- How long do I have to file my claim?
While Minnesota Statutes allow up to 180 days to report a Workers’ Compensation claim, the University requires employees to report work-related injuries/illnesses as soon as reasonably possible. The University requires this to ensure that all medical and lost time benefits that may be owed to an employee begin in a timely matter. The longer you wait to report a work-related injury, the higher the risk in delay or losing compensation benefits.
- Will I need a lawyer to file my claim or receive benefits?
The charge of the University's Director of Risk Management and Insurance to the University's Claims Administrator is simple and direct:
Immediately pay University employees' Workers’ Compensation claims to the full extent required by Minnesota's Workers’ Compensation law.
While injured employees have the right to hire an attorney, we have made diligent efforts to ensure injured employees have received all benefits entitled to them under Minnesota Workers’ Compensation statutes and administrative rules. By doing this, we hope no employee feels they need to obtain an attorney.
- Will my Workers’ Compensation recovery change if I hire a lawyer?
The Workers’ Compensation laws allow attorneys to take 25% of the first $4,000 of your benefits and 20% of the next $60,000 of your benefits.
- My claim was denied and I don't understand why. Now what?
The Workers’ Compensation system is governed by state laws and also decades of case law. The rules are not intuitive, and certain denials may be hard to understand. Please know that any and all denials the Claims Administrator proposes to make have been personally reviewed by the University's Director of Risk Management and Insurance to ensure University employees’ claims are reviewed for compensability in accordance with Minnesota Workers’ Compensation laws.
If you have questions regarding a claim denial, discussion with one or more of these resources may help clarify the decision:
- Who pays for Workers’ Compensation claims?
The University is self-insured for Workers’ Compensation. Losses are borne by the University and are not transferred to an outside insurer.
- I'm not sure if my injury is work-related. What should I do?
If you are not sure if an injury is related to work, notify your supervisor of the injury and file a claim. The assigned Claims Administrator will help make the determination.
- How are my wage loss benefits calculated?
If your physician authorizes temporary total or partial disability from work for more than three calendar days, you may be entitled to receive wage-loss benefits from our Claims Administrator. The first three days of lost time are considered a waiting period and will not be paid unless you are disabled beyond the 10th day from your first date of lost time.
In the event of temporary total disability, your weekly compensation rate is generally two-thirds of your 26-week average weekly wage at the time of your injury, subject to statutory minimums and maximums.
In the event of temporary partial disability, your weekly compensation rate is generally two-thirds of the difference between your 26-week average weekly wage and the wage you are able to earn in your partially disabled condition.
- For compensable Lost Time injuries, what are my wage replacement options?
Under Minnesota Statute, Sedgwick Claims Management will pay your wage loss benefits upon acceptance of your Workers’ Compensation lost time claim. They will pay the two-thirds of your average weekly wage, subject to statutory minimums and maximums. Your leave balance(s) will be unaffected.
In addition to the statutory wage loss benefit, you may also consider a wage replacement option from the University. You are able to replace the additional one-third of your wage loss using your leave balance(s) at the University. You must use your sick leave first, followed by vacation and comp leave.
If your Lost Time claim has not yet been accepted as compensable, you may choose to receive 100% of your wages from the University, subject to paid leave being available to you, by using your leave balance(s). Upon the acceptance of your claim, you will receive the statutory two-thirds of your average weekly wage from Sedgwick Claims Management backdated to the beginning of your wage loss. Once Sedgwick applies the statutory wage loss payment, this will result in an overpayment. At that time, you will be required to reimburse the University the amount of your payment from Sedgwick (the two-thirds of your average weekly wage).
- Must I return to work after my physician releases me to return with restrictions?
Yes! The University's top priority is getting you well quickly and having you rejoin our University community. The University aspires to emphasize Return to Work. Working, even if only in a limited capacity; it gets you up and moving and keeps you in a healthy routine. Absence Management Research has consistently demonstrated that employees heal more quickly and completely if they remain active, at work with co-workers.
Physicians’ restrictions minimize the possibility of reinjury if you follow their guidelines and instructions. Access Consultants within the Disability Resource Center (URETURN) are available to provide objective review of jobs. If necessary, Access Consultants will seek clarity with your provider if questions need to be addressed.
If you are concerned that the job provided is not consistent with the restrictions, discuss the issue with your supervisor, URETURN personnel, your adjuster, and/or your doctor.
- I want to return to work, but need some assistance. Who can help?
- Your supervisor should be your primary resource. In addition, Access Consultants will serve as an objective facilitator whose role is to engage the supervisor and the employee in the interactive process
- Assistance is also available from the University’s Disability Resource Center Office (URETURN). This Office has ramped up its involvement with employee’s addressing work related injuries and illnesses.
- Who should complete the First Report of Injury? The injured employee? Their supervisor? Someone else?
Although the State of Minnesota does not specifically indicate who must complete the First Report of Injury, we recommend as a 'Best Practice' that the Supervisor complete this form in close consultation with the injured employee. The most important aspect of the First Report of Injury is to complete it to the best of your ability and submit it immediately.
- I have more questions. Where should I go for answers?